Association between donor-specific antibodies and acute rejection and resolution in small bowel and multivisceral transplantation

Hsin Lin Tsai, Eddie R. Island, Jei Wen Chang, Ignacio Gonzalez-Pinto, Panagiotis Tryphonopoulos, Seigo Nishida, Gennaro Selvaggi, Akin Tekin, Jang Moon, David Levi, E. Steve Woodle, Phillip Ruiz, Debbie Weppler, Oscar K S Lee, Andreas G. Tzakis

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background. Donor-specific antibodies (DSA) are associated with acute kidney graft rejection, but their role in small bowel/multivisceral allograft remains unclear. We carried out a prospective study to understand the impact of DSA in the setting of intestinal allograft rejection. Methods. Thirteen patients (15 grafts) were serially evaluated for DSA levels pre-and posttransplant. DSA was determined by Luminex and the results were interpreted as fluorescence intensity (FI), with FI more than 3000 considered positive. Results. The clinical rejection episodes in allografts were significantly associated with the presence of DSA (P=0.041).We obtained 291 biopsy samples from graft ileum and date-matched DSA assay reports. Sixty-three (21.65%) of the biopsies showed acute rejection. The appearance of DSA were preformed (n=5, anti-human leukocyte antigen class II=3, anti-class I and II=2), de novo (n=4, 15.25±4.72 days after transplantation, anti-class II=1, and anti-class I and II=3) and never (n=6). Among the 63 biopsies, 30(47.6%) had significant correlations with positive DSA (kappa=0.30, P<0.001) and manifested severe rejection grade (P=0.009). Conclusions. In this cohort of small bowel/multivisceral transplantation patients, there was a high incidence of DSA. The presence of DSA should alert the clinical team of a higher risk of rejection, and reduction of the FI is clinically associated with resolution. Serial endoscopy guided biopsies combined with simultaneous DSA measurement in postintestinal transplantation follow-up is an effective means of screening for cellular and humoral-based forms of acute rejection.

Original languageEnglish
Pages (from-to)709-715
Number of pages7
JournalTransplantation
Volume92
Issue number6
DOIs
StatePublished - Sep 27 2011

Fingerprint

Transplantation
Tissue Donors
Antibodies
Allografts
Biopsy
Fluorescence
Rejection (Psychology)
Transplants
Graft Rejection
Risk Reduction Behavior
HLA Antigens
Ileum
Endoscopy
Prospective Studies
Kidney
Incidence

Keywords

  • Acute rejection
  • Donor-specific antibody
  • Multivisceral transplantation
  • Small bowel transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Tsai, H. L., Island, E. R., Chang, J. W., Gonzalez-Pinto, I., Tryphonopoulos, P., Nishida, S., ... Tzakis, A. G. (2011). Association between donor-specific antibodies and acute rejection and resolution in small bowel and multivisceral transplantation. Transplantation, 92(6), 709-715. https://doi.org/10.1097/TP.0b013e318229f752

Association between donor-specific antibodies and acute rejection and resolution in small bowel and multivisceral transplantation. / Tsai, Hsin Lin; Island, Eddie R.; Chang, Jei Wen; Gonzalez-Pinto, Ignacio; Tryphonopoulos, Panagiotis; Nishida, Seigo; Selvaggi, Gennaro; Tekin, Akin; Moon, Jang; Levi, David; Woodle, E. Steve; Ruiz, Phillip; Weppler, Debbie; Lee, Oscar K S; Tzakis, Andreas G.

In: Transplantation, Vol. 92, No. 6, 27.09.2011, p. 709-715.

Research output: Contribution to journalArticle

Tsai, HL, Island, ER, Chang, JW, Gonzalez-Pinto, I, Tryphonopoulos, P, Nishida, S, Selvaggi, G, Tekin, A, Moon, J, Levi, D, Woodle, ES, Ruiz, P, Weppler, D, Lee, OKS & Tzakis, AG 2011, 'Association between donor-specific antibodies and acute rejection and resolution in small bowel and multivisceral transplantation', Transplantation, vol. 92, no. 6, pp. 709-715. https://doi.org/10.1097/TP.0b013e318229f752
Tsai, Hsin Lin ; Island, Eddie R. ; Chang, Jei Wen ; Gonzalez-Pinto, Ignacio ; Tryphonopoulos, Panagiotis ; Nishida, Seigo ; Selvaggi, Gennaro ; Tekin, Akin ; Moon, Jang ; Levi, David ; Woodle, E. Steve ; Ruiz, Phillip ; Weppler, Debbie ; Lee, Oscar K S ; Tzakis, Andreas G. / Association between donor-specific antibodies and acute rejection and resolution in small bowel and multivisceral transplantation. In: Transplantation. 2011 ; Vol. 92, No. 6. pp. 709-715.
@article{f2405eadd05543d3935fd373b719b0e1,
title = "Association between donor-specific antibodies and acute rejection and resolution in small bowel and multivisceral transplantation",
abstract = "Background. Donor-specific antibodies (DSA) are associated with acute kidney graft rejection, but their role in small bowel/multivisceral allograft remains unclear. We carried out a prospective study to understand the impact of DSA in the setting of intestinal allograft rejection. Methods. Thirteen patients (15 grafts) were serially evaluated for DSA levels pre-and posttransplant. DSA was determined by Luminex and the results were interpreted as fluorescence intensity (FI), with FI more than 3000 considered positive. Results. The clinical rejection episodes in allografts were significantly associated with the presence of DSA (P=0.041).We obtained 291 biopsy samples from graft ileum and date-matched DSA assay reports. Sixty-three (21.65{\%}) of the biopsies showed acute rejection. The appearance of DSA were preformed (n=5, anti-human leukocyte antigen class II=3, anti-class I and II=2), de novo (n=4, 15.25±4.72 days after transplantation, anti-class II=1, and anti-class I and II=3) and never (n=6). Among the 63 biopsies, 30(47.6{\%}) had significant correlations with positive DSA (kappa=0.30, P<0.001) and manifested severe rejection grade (P=0.009). Conclusions. In this cohort of small bowel/multivisceral transplantation patients, there was a high incidence of DSA. The presence of DSA should alert the clinical team of a higher risk of rejection, and reduction of the FI is clinically associated with resolution. Serial endoscopy guided biopsies combined with simultaneous DSA measurement in postintestinal transplantation follow-up is an effective means of screening for cellular and humoral-based forms of acute rejection.",
keywords = "Acute rejection, Donor-specific antibody, Multivisceral transplantation, Small bowel transplantation",
author = "Tsai, {Hsin Lin} and Island, {Eddie R.} and Chang, {Jei Wen} and Ignacio Gonzalez-Pinto and Panagiotis Tryphonopoulos and Seigo Nishida and Gennaro Selvaggi and Akin Tekin and Jang Moon and David Levi and Woodle, {E. Steve} and Phillip Ruiz and Debbie Weppler and Lee, {Oscar K S} and Tzakis, {Andreas G.}",
year = "2011",
month = "9",
day = "27",
doi = "10.1097/TP.0b013e318229f752",
language = "English",
volume = "92",
pages = "709--715",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Association between donor-specific antibodies and acute rejection and resolution in small bowel and multivisceral transplantation

AU - Tsai, Hsin Lin

AU - Island, Eddie R.

AU - Chang, Jei Wen

AU - Gonzalez-Pinto, Ignacio

AU - Tryphonopoulos, Panagiotis

AU - Nishida, Seigo

AU - Selvaggi, Gennaro

AU - Tekin, Akin

AU - Moon, Jang

AU - Levi, David

AU - Woodle, E. Steve

AU - Ruiz, Phillip

AU - Weppler, Debbie

AU - Lee, Oscar K S

AU - Tzakis, Andreas G.

PY - 2011/9/27

Y1 - 2011/9/27

N2 - Background. Donor-specific antibodies (DSA) are associated with acute kidney graft rejection, but their role in small bowel/multivisceral allograft remains unclear. We carried out a prospective study to understand the impact of DSA in the setting of intestinal allograft rejection. Methods. Thirteen patients (15 grafts) were serially evaluated for DSA levels pre-and posttransplant. DSA was determined by Luminex and the results were interpreted as fluorescence intensity (FI), with FI more than 3000 considered positive. Results. The clinical rejection episodes in allografts were significantly associated with the presence of DSA (P=0.041).We obtained 291 biopsy samples from graft ileum and date-matched DSA assay reports. Sixty-three (21.65%) of the biopsies showed acute rejection. The appearance of DSA were preformed (n=5, anti-human leukocyte antigen class II=3, anti-class I and II=2), de novo (n=4, 15.25±4.72 days after transplantation, anti-class II=1, and anti-class I and II=3) and never (n=6). Among the 63 biopsies, 30(47.6%) had significant correlations with positive DSA (kappa=0.30, P<0.001) and manifested severe rejection grade (P=0.009). Conclusions. In this cohort of small bowel/multivisceral transplantation patients, there was a high incidence of DSA. The presence of DSA should alert the clinical team of a higher risk of rejection, and reduction of the FI is clinically associated with resolution. Serial endoscopy guided biopsies combined with simultaneous DSA measurement in postintestinal transplantation follow-up is an effective means of screening for cellular and humoral-based forms of acute rejection.

AB - Background. Donor-specific antibodies (DSA) are associated with acute kidney graft rejection, but their role in small bowel/multivisceral allograft remains unclear. We carried out a prospective study to understand the impact of DSA in the setting of intestinal allograft rejection. Methods. Thirteen patients (15 grafts) were serially evaluated for DSA levels pre-and posttransplant. DSA was determined by Luminex and the results were interpreted as fluorescence intensity (FI), with FI more than 3000 considered positive. Results. The clinical rejection episodes in allografts were significantly associated with the presence of DSA (P=0.041).We obtained 291 biopsy samples from graft ileum and date-matched DSA assay reports. Sixty-three (21.65%) of the biopsies showed acute rejection. The appearance of DSA were preformed (n=5, anti-human leukocyte antigen class II=3, anti-class I and II=2), de novo (n=4, 15.25±4.72 days after transplantation, anti-class II=1, and anti-class I and II=3) and never (n=6). Among the 63 biopsies, 30(47.6%) had significant correlations with positive DSA (kappa=0.30, P<0.001) and manifested severe rejection grade (P=0.009). Conclusions. In this cohort of small bowel/multivisceral transplantation patients, there was a high incidence of DSA. The presence of DSA should alert the clinical team of a higher risk of rejection, and reduction of the FI is clinically associated with resolution. Serial endoscopy guided biopsies combined with simultaneous DSA measurement in postintestinal transplantation follow-up is an effective means of screening for cellular and humoral-based forms of acute rejection.

KW - Acute rejection

KW - Donor-specific antibody

KW - Multivisceral transplantation

KW - Small bowel transplantation

UR - http://www.scopus.com/inward/record.url?scp=80052688843&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052688843&partnerID=8YFLogxK

U2 - 10.1097/TP.0b013e318229f752

DO - 10.1097/TP.0b013e318229f752

M3 - Article

C2 - 21804443

AN - SCOPUS:80052688843

VL - 92

SP - 709

EP - 715

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 6

ER -